儿童及高龄边缘供肝在成年肝移植中的临床应用初步经验  

The preliminary experience of child and older marginal donation in adult liver transplantation

作　　者：黄新立[1] 李国强[1] 母小新[1] 秦建杰[1] 周澍[1] 李梦芸[1] 潘熊熊[2] 谈珊柏[2] 孙倍成[1] 

机构地区：[1]南京医科大学第一附属医院肝脏外科,江苏南京210029 [2]南京医科大学第一附属医院麻醉科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2016年第2期193-196,209,共5页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家杰出青年基金课题资助(81225017)

摘　　要：目的 :探讨公民逝世后器官捐献(DCD)与年龄相关的边缘供肝临床肝移植应用经验。方法 :对南京医科大学第一附属医院2013年12月至2015年10月3例与年龄相关的边缘供肝应用于肝移植的临床情况进行回顾分析,包括供受者双方的临床资料及受者术后短期恢复情况。结果:3例供者其中2例实施中国Ⅲ类即脑-心双死亡(DBCD)器官捐献,另外1例实施中国Ⅱ类器官捐献。3例供者中1例为7岁儿童,另外2例分别为79岁老年男性和83岁老年女性。3例肝移植受者术后恢复顺利,肝功能恢复良好,其中儿童供肝肝移植患者术后1个月出现幻觉、幻听及被害妄想等神经精神症状,经治疗痊愈。结论:本研究在一定程度上说明儿童和老年边缘供肝只要科学评估和合理应用于合适的受体一样可以获得良好的效果,年龄不应该成为独立的肝移植禁忌证,在做好充分评估的基础上,与年龄相关的边缘供肝应用于肝移植具有较高的可行性。Objective：To explore the application of Donation after citizen＇s death（DCD）and age-related marginal donor for liver transplantation in clinical liver transplantation. Methods：From December 2013 to October 2015,3 cases of DCD age-related marginal donors for liver transplantation were included in the Liver Transplantation Center,the First Affiliated Hospital of Nanjing Medical University. The clinical situation of liver transplantation was analyzed,retrospectively,including clinical data of both donors,and recipients, and short-term recovery of recipients. Results：Among the 3 cases,2 cases were performed by Chinese Ⅲ DCD ethical standard,and 1 cases was performed by Chinese Ⅱ DCD ethical standard. Among the 3 cases,one case was 7 years old,the other two cases were 79 years old and 83 years old. Three recipients recovered smoothly and liver function recovered well. The recipients by children liver appeared hallucinations,auditory hallucination and delusion of neuropsychiatric symptoms after 1 month,and healed after treatment. Conclusion：The study suggests that to some extent,as long as the scientific evaluation and reasonable application of the appropriate receptors,the liver transplantation of DCD marginal donors can obtain good results. Age should not be an independent taboo for liver transplant. On the basis of adequate assessment,the age-related marginal donor for liver transplantation is feasible.

关 键 词：公民逝世后器官捐献 边缘供肝 肝移植 

分 类 号：R657.3[医药卫生—外科学]